Working With Your City or Public Health Departments to Get People Covered
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Presented at Enroll America's 2015 State of Enrollment conference.
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Working With Your City or Public Health Departments to Get People Covered
- 1. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Working with Your Public Health Departments to Get People Covered Jennifer Roniger, MPH, Enroll America Malcolm Williams, Ph.D., RAND Daphne Pie, Seattle & King County Public Health Department Maria De La Cruz, Houston Department of Health and Human Services
- 2. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Daphne Pie, Manager-Public Health-Seattle & King County-Access & Outreach | 06.05.15 Enroll King County! What Did We Do & How Did We Do It?
- 3. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Who Are We? King County, Washington State State-based exchange— Wahealthplanfind.org Expanded Medicaid—Apple Health 1.8 million people; 39 cities Public Health-Seattle & King County: 10th largest health department Lead In-Person Assister Organization for King County region 14% Uninsured Rate before the Affordable Care act
- 4. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 2% 26% 0% 5% 10% 15% 20% 25% 30% Mercer Isle/Pt Cities Bear Creek/Carnation/Duvall Vashon Island Sammamish Issaquah Newcastle/Four Creeks Snoqualmie/North Bend/Skykomish Shoreline Kirkland Redmond Covington/Maple Valley Kenmore/LFP Bellevue Seattle Bothell/Woodinville Renton/Fairwood Black Diamond/Enumclaw/SE County East Federal Way Kent Burien Auburn Federal Way North Highline SeaTac/Tukwila Des Moines/Normandy Park Lack of health insurance by Health Reporting Area, age 18 to 64, King County, 2007-2011 average Source: BRFSS, produced by PHSKC, APDE, 9/2012 13X difference Lack of Health Insurance Common
- 5. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Snap Shot of the Uninsured in King County Deeper Dive of the Uninsured 26% American Indian/Alaskan Native 44% Hispanic Uninsured Adults by Race/Ethnicity 15% Asian 19% Pacific Islanders King County, Washington State 25% Black 16% White
- 6. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Overview of Enrollment Efforts
- 7. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org How Did We Roll Out Our Strategies? Slide and Content Source: Hutchinson, “Three Innovative Strategies: King County’s Quest to Cover the Uninsured” Solicit active support from local leaders and create opportunities for them to lead “Top down approach” Defer detailed decision-making to grassroots organizations “Allow your community experts to drive the work—cover the gaps” Frame enrollment in terms that will resonate with the community “We don’t use terms that are foreign to our communities” Invite participation from organizations outside of health- care “In our network we had various types of agencies” Utilize existing partnership networks and bring all organizations to the table— especially smaller ones “DSHS, Health Care Authority, City of Seattle, various networks” Convene a regular forum to address technical issues and share solution “First Friday Forum”
- 8. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Helping Our Community Partners GOAL: Always achieve system-wide changes that improve access to health care among the most vulnerable people by encouraging community stakeholders to participate in this effort. We asked our partners to help us with following for HCR implementation: 1. Analysis (Outreach, enrollment process, training issues) 2. Identify (Problems, gaps, barriers) 3. Educate (Help us educated the community—King wide blitz) 4. Advocate (For change with DSHS, Exchange & Health Care Authority) How Did We Help Our Community Partners Through System Building?
- 9. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Assure Access to King County Residents We collaborate with our community partners to design outreach strategies! Ø Reviewed data of the uninsured in 39 cities. Determined current outreach partners & looked at the gap areas to determine if we could get non-traditional help Ø Focused on race/ethnicity/special populations and provided outreach assistance at 34 of the 39 cities. Ø Manages the In-Person Assister network which has 310 certified navigators and over 40 partners. Ø Developed outreach strategies specific to community colleges, technical colleges, universities and the Promotora programs. Ø Designed a separate outreach model for large housing complexes.
- 10. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Outreach 1. Allow community partners to determine how and where they do their outreach. 2. Provide outreach in “gap” areas with little or limited outreach. 3. 50+ outreach locations in rural and underserved communities. 4. When outreach isn’t possible in an area, determine how to assure access: a) develop Promotora programs b) outreach at libraries c) community fairs including Apple Health insurance providers d) Community blogs & working with local government Provide services to the most vulnerable 5. Translate materials into various languages (Somali, Arabic, French, Burmese, Samoan, Purepecha) 6. Maintain an outreach calendar and coordinated outreach in King County.
- 11. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Four enhanced users, allows us to clear our network partners system errors Work with the Exchange on unresolved tickets and provide more support and training Outreach at the United Way Tax Preparation sites to educate clients about the tax penalty and enroll Fewer outreach events Enhanced outreach in the rural area’s of King County Update our events/ enrollment calendar Distribute materials in 8 additional languages: Purepecha, Japanese, Arabic, Punjabi, French, Tigrigna, Burmese & Swahili Reviewing the data to determine whose left for enrollment Open Enrollment 2 Objective: What Did We Do?
- 12. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Did King County Achieve Their Goals? 47,706 44,431 43,594 52,754 10/31/2014 11/30/2014 1/31/2015 3/6/2015 10/31/2014 11/30/2014 1/31/2015 3/10/2015 Everyone else New adults 125,373 130,625 123,714 139,398 304,561307,403 During Open Enrollment 1 & 2 the In-Person Assister Network enrolled 134,028 people into health insurance. Overall it’s estimated that King County reduced the uninsured rate to about 9%. Qualified Health Plans Apple Health Apple Health
- 13. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Enrollment-Based Estimates of Uninsurance by Age 4.3% 16% 14% 12% 3.6% 9% 8% 7% Age 0-17 Age 18-64 Age 18+ All ages 2013 March 31, 2014 Notes: 1. 2013 uninsurance estimates from US Census Bureau, American Community Survey, 2013. 2. March 2014 uninsurance estimates based on number of uninsured individuals who enrolled in insurance between October 1, 2013 and March 31, 2014 and population estimates from American Community Survey, 2012. 3. For age 0-17 enrollments, proportion of enrollees assumed to be previously uninsured set equal to the ratio of the 2012 King County child uninsurance rate to the non-elderly adult insurance rate, which is 30% (ACS, 2012). 4. Uninsurance rates for ages 18+ and all ages incorporate number of Medicare enrollments and number of uninsured adults age 65+ in 2012, and assume no change between 2012 and March 31, 2014.
- 14. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org What’s Happening for the 3rd Open Enrolment Period? Formulate strategies with our partners with a target on Qualified Health Plan Enrollments Target outreach to zip codes that appear to have high numbers of uninsured July = Roll out new outreach for small minority owned businesses Planning another large summer enrollment event in one of the highest uninsured areas in King County. Incorporating the new Orca LIFT transportation program *Still waiting for race/ethnicity data Although we did a good job in network, we have much work to do!
- 15. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Data Source: Enrollments – Health Care Authority; Adults age 18-64 with income less than 138% of Federal Poverty Level – American Community Survey 2008-2012 ZIP Code Number not enrolled 98002 2,313 98003 2,636 98004 1,164 98007 1,308 98011 1,251 98023 1,782 98030 2,396 98032 1,838 98052 1,658 98102 1,176 98115 1,568 98118 2,137 98119 1,901 98121 2,123 98122 2,594 98125 1,841 98133 1,581 98146 1,333 98168 1,301 98198 2,331 TOTAL 36,232 Top 20 ZIPs with the largest estimated number of income- eligible adults not enrolled in Apple Health
- 16. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org ZIP Code Number not enrolled 98002 8,593 98003 11,222 98023 10,004 98030 8,013 98031 9,668 98032 8,296 98034 7,298 98042 7,451 98052 7,303 98056 7,972 98058 8,215 98092 8,090 98103 10,858 98115 7,327 98118 8,533 98122 7,570 98125 8,165 98133 10,884 98168 9,515 98198 8,625 TOTAL 173,602 Top 20 ZIPs with the largest estimated number of QHP tax credit-eligible adults not enrolled in Qualified Health Plans Data Source: Enrollments – Health Benefit Exchange; Adults age 18-64 with income between 138 and 399% of Federal Poverty Level – American Community Survey 2009-2013
- 17. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org QUESTIONS?
- 18. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org Daphne Pie Manager Daphne.pie@kingcounty.gov 206-263-8369 www.kingcounty.gov/health/access 1-800-756-5437 Callista Kennedy (206) 263-‐8368 Callista.kennedy@kingcounty Outreach Specialist Carmen Olvera (206) 296-‐3948 Carmen.olvera@kingcounty.gov Outreach Specialist-‐Spanish BreF Downey (206) 263-‐8373 BreF.downey@kingcounty.gov Outreach Specialist-‐Spanish Luis Salazar (206) 263-‐8261 Luis.salazar@kingcounty.gov Outreach Specialist-‐Spanish Penny Lara (206) 263-‐8372 Penny.lara@kingcounty.gov Project Manager/Health Care Reform Miguel Urquiza (206) 296-‐9875 Miguel.urquiza@kingcounty.gov EducaXon Consultant I Cindy Mai (206) 296-‐3949 Cindy.mai@kingcounty.gov Outreach Specialist-‐Vietnamese Javier Amaya (206) 263-‐8311 Javier.amaya@kingcounty.gov EducaXon Consultant Ii Willie Allen (253) 874-‐642 Willie.allen@kingcounty.gov Educator Consultant II/Program Supervisor Bishaw Gezie (206) 296-‐3943 Bishaw.gezie@kingcounty.gov Outreach Specialist-‐Amharic How to Connect
- 19. © 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org How to Connect Enrollgulfcoast.com Maria De La Cruz Maria.Delacruz@houstontx.gov Rosy Mota RMota@enrollamerica.org